Jemds.com Original Article J. Evolution Med. Dent. Sci./ eISSN- 2278-4802, pISSN- 2278-4748/ Vol. 5/ Issue 45/ June 06, 2016 Page 2809 STUDY OF MORTALITY AND MORBIDITY OF PATIENTS OPERATED IN EMERGENCY FOR ILEAL PERFORATION PERITONITIS IN CENTRAL INDIA Lal Mani Singh 1 , Ashok Nayak 2 1 Assistant Professor, Department of General Surgery, S. S. Medical College, Rewa. 2 Assistant Professor, (Neuro) Department of General Surgery, S. S. Medical College, Rewa. ABSTRACT Ileal perforation peritonitis is a common surgical emergency in the Indian subcontinent and in tropical countries. It is reported to constitute the fifth common cause of abdominal emergencies due to high incidence of enteric fever and tuberculosis in these regions. METHODS This study included 94 patients diagnosed with ileal perforation, admitted and treated in the Department of General Surgery from February 2011 to January 2012 in an Educational Institute of Central India. RESULT Out of the 94 patients studied, 72 (76.59%) were males and 22 (23.4%) were females; 8 patients had hypertension, 6 patients had diabetes and 8 patients both HT and DM; 48 patients were diagnosed to have typhoid fever and received antibiotics prior to hospitalization for perforation; 7 patients were taking ATT from DOT’S centre. All the 11 patients who died had symptoms for more than 24 hours. Seven of the 83 survivors had symptoms for more than five days. The surgical intervention was initiated within the first 24 hours of admission in 68 (72.34%) of the patients. The overall mortality rate was 11.7% (11 patients). CONCLUSION Early recognition, timely surgical intervention, appropriate antibiotics and surgical technique, pre-operative, post and peri– operative care play a key role in reducing mortality in ileal perforation. KEYWORDS Ileal Perforation, Mortality, Morbidity. HOW TO CITE THIS ARTICLE: Singh LM, Nayak A. Study of mortality and morbidity of patients operated in emergency for ileal perforation peritonitis in Central India. J. Evolution Med. Dent. Sci. 2016;5(45):2809-2812, DOI: 10.14260/jemds/2016/656 INTRODUCTION Acute generalized peritonitis from ileal perforation is a potentially life-threatening condition. It is the most important surgical complication of typhoid enteritis with significant morbidity and mortality and is very common in the Indo- Pakistan sub-continent. The mortality ranges between 9 and 43% with many of the survivors having severe wound infection and a history of long hospital stay. [1] Many factors such as late presentation, inadequate pre-operative resuscitation, delayed operation, the number of perforations and the extent of faecal peritonitis have been found to have a significant effect on the prognosis. MATERIAL AND METHODS This study included 94 patients diagnosed with ileal perforation, admitted and treated in the Department of General Surgery from February 2011 to January 2012 in an Educational Institute of Central India. A thorough history was taken and detailed examination done as per proforma. The cases were evaluated with regard to age, gender and clinical features, investigations, and intra–operative findings, type Financial or Other, Competing Interest: None. Submission 08-04-2016, Peer Review 12-05-2016, Acceptance 19-05-2016, Published 06-06-2016. Corresponding Author: Dr. Lal Mani Singh, Department of General Surgery, Sanjay Gandhi Memorial Hospital, Rewa-486001, Madhya Pradesh. E-mail: lalmnsingh@gmail.com DOI: 10.14260/jemds/2016/656 of surgery, morbidity and mortality. All patients initially presented to the emergency department, because of acute abdomen. They were subjected to erect X–ray abdomen, chest X–ray PA view, complete blood count, urine analysis, renal function test, serum electrolytes. All patients underwent surgery after pre–operative resuscitation; the patients were subjected to exploratory laparotomy under General Anaesthesia. Operative findings were recorded and edge biopsy at the perforation site or the resected specimen was sent for histopathological examination. The type of surgical procedure was decided on basis of operative findings. Delay in operation was the time period calculated from the time of onset of severe symptomatology like exacerbation of abdominal pain, distention and vomiting. Postoperatively, the patients were followed up for any complication like faecal fistula. RESULT Out of the 94 patients studied, 72 (76.59%) were males and 22 (23.4%) were females. The youngest was 16 years old and oldest was 85 years. Type of operative procedure and mortality are depicted in (Table 1). All patients were septic on admission. The most common presentation was pain abdomen seen in 85 patients with mean duration of 3.49 days. Fifty two patients had history of pain abdomen less than 4 days. Bowel disturbances were present in 92 (97.87%) patients, out of whom 72 patients had constipation, 12 patients had loose stools and 8 patients had vomiting. Comorbidities were also present in 22 patients; 8 patients had hypertension, 6 patients had diabetes and 8 patients both HT and DM; 48 patients were